The Level of Competence of Novice Registered Nurses Custom Essay

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The Level of Competence of Novice Registered Nurses Custom Essay

For any newly licensed registered nurse about to embark on her nursing career, the concept of competence is of great personal and professional significance. Questions abound regarding what it means to be a competent nurse and how competence is measured. Nursing competency is defined by the National Council for State Boards of Nursing (NCSBN) as the “application of knowledge, interpersonal decision-making and psychomotor skills expected for the practice role within the context of public health.” (NCSBN, 2005, p. 1) Continuing competency is not new to healthcare, nor is it new to the nursing profession. Continuing competence is defined as “the ongoing commitment of a registered nurse to integrate and apply the knowledge, skills and judgment with the attitudes, values and beliefs required to practice safely, effectively and ethically in a designated role and setting”

Discussion: ethics and the role of the institutional review board

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As graduate students at Walden University, you are responsible for designing and conducting research that is ethical in all aspects. Your course text, Surviving Your Dissertation describes the critical norms for conducting ethical research: (a) Validity of the research, (b) competency of the researcher, (c) beneficence of the research, (d) special populations, and (e) informed consent (pp. 275–276). Some of these norms arose from the scrutiny of well-known controversial, unethical studies.

Your course text Research Methods for Criminal Justice and Criminology describes three “illustrative cases” in Chapter 3: (a) Trouble in the Tearoom and (b) The Stanford Prison Experiment. You may wish to investigate both of these studies more thoroughly.

In this Discussion, you will examine the role of the IRB, your responsibilities for ensuring that you design an ethical study, and the ways in which you can reduce or eliminate ethical challenges. To prepare for this Discussion, review the Dissertation and Ethics resources listed for the week.

ASSIGNMENT:

Explain the role of the IRB

Explain ethical problems you might experience if you were to conduct research on your identified topic of research.

Analyze the impact of these potential ethical challenges. How might participants be affected, for example?

Devise ways you might address these ethical challenges to the IRB to ensure integrity in the research process.

Analyze the ethical values you hold that underlie your response.

Describe a time when you made a meaningful contribution to others in which the greater good was your focus. Discuss the challenges and rewards of making your contribution.

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Describe a time when you made a meaningful contribution to others in which the greater good was your focus. Discuss the challenges and rewards of making your contribution.

 

College essay writing service
Question description
Your essay will be reviewed by the Admissions Committee so we may learn more about you; it also serves as a writing sample. Please submit a concise essay (200–word limit) which addresses one of the following four questions:
Why nursing and why University of Maryland school of nursing?
Tell a story from your life or describe an experience that demonstrates your character or helped shaped who you are.
Describe a time when you made a meaningful contribution to others in which the greater good was your focus. Discuss the challenges and rewards of making your contribution.
Has there been a time when you have had a long-cherished or accepted belief challenged? How did you respond? How did the challenge affect your beliefs?
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Risk Factors of Posttraumatic Stress Disorder in Veterans

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The Few, The Proud, The Afflicted:

Risk Factors of Posttraumatic Stress Disorder in Veterans

Abstract

In the current research paper, an analysis of posttraumatic stress disorder (PTSD) in veterans was conducted. It is evident that many veterans suffer from PTSD and many cases result in alcohol abuse, drug abuse, a failing family life, domestic violence, extreme aggression, withdrawal, detachment, homelessness, and an alarming rate of suicide. This paper looks at current issues that veterans are experiencing due to PTSD, possible risk factors that my increase the manifestation of PTSD, and possible treatments.

Chapter 1: The Few

Post-Traumatic Stress Disorder (PTSD) has been a part of many of our U.S. wars throughout history, but never had a true clinical diagnosis for it. During each war; PTSD had many different names such as “soldier’s heart” during the Civil War, “shell shock” World War I, and World War II and Korean war known as “combat fatigue” (Langer pg. 50). It wasn’t until 1980 that The American Psychiatric Association introduced the proper terminology as Post-Traumatic Stress Disorder (Langer pg. 51). There are three different ways states that PTSD can manifest. One is intrusive recollection; it’s where the sufferer is constantly reliving the traumatic event or events. They suffer from hallucinations, illusions, and flash back episodes daily. Second is avoidance and numbing are when the sufferer is avoiding any stimuli that would remind them of their traumatic event. They also avoid remembering the important parts of their trauma. Third is hyper-arousal; is where the sufferer is extremely irritable, has anger issues, outburst, and difficulties with sleep (Langer pgs. 51-52)

A 28-year-old veteran Justin Michael Crowley-Smilek from Maine was convicted of assault after he battered someone over the head with a flashlight. He was then court ordered to undergo a psychological exam to address his reoccurring mental issues after returning from Afghanistan as a U.S. Army Ranger. The day after his court appearance, the Justin returned to the courthouse, threatened a police officer with a knife, and was shot to death (Hannon, 2011). This man was my sister in laws brother’s best friend throughout is childhood and my sister in laws best friend’s brother. The four of them used to catch frogs in the pond, watch Saturday cartoons, and stay up late and eat junk food at sleepovers together. His family said he did not know how to ask for help and sadly, this may have been his way.

A 46-year-old veteran

It is crucial that PTSD in veterans be addressed so that the search for proactive measures, encouragements to come forward, and better treatments continue.

Chapter 2: The Proud: The Battle Within


Symptoms of Posttraumatic Stress Disorder

The American Psychiatric Association defines posttraumatic stress disorder (PTSD) as “a psychiatric condition that is experienced by a subset of individuals after exposure to an event that involved life threat and elicited feelings of fear, helplessness, and/or horror in the individual” (American Psychiatric Association, 2000). According to a recent study on PTSD in veterans, research shows that 16% of deployed veterans suffer from PTSD whereas only 7% of the United States suffers from PTSD (Gates, Holowka, Vasterling, Keane, Marx, & Rosen, 2012). It is important to note that these 16% are those veterans and active duty members that come forward to seek help; there may be an unrepresented amount that does not come forward for fear of stigma, embarrassment, shame, or other consequences.

The DSM-IV states that when a person suffers from PTSD, they must have experienced a traumatic event and their response to this event included immense fear (American Psychiatric Association, 2000). It is obvious that when an individual goes to war, they are more likely going to experience a situation with these factors. After the event has been experienced, a minimum of one symptom from the category of “intrusive recollection”, three symptoms from “avoidant/numbing symptoms,” and two symptoms from “hyper arousal symptoms” must be present for the diagnosis of PTSD (American Psychiatric Association, 2000). The category of “intrusive recollection” has symptoms such as stressing over the past event through thoughts or pictures, dreams of the event, a feeling that the event is reoccurring, psychological stress over verbal or visual reminders of the event, and physical reaction to reminders of the event. “Avoidant/numbing” symptoms are considered any attempt to avoid talking about the event, avoiding people, places and activates, detaching, and others. “Hyper arousal” has such symptoms as problems with sleep, irritability, and easily startled. These symptoms must all last more than one month (American Psychiatric Association, 2000).

PTSD can increase a person’s dependency on alcohol and drugs. A study showed that people who suffer from PTSD or experienced any traumatic event were more likely to be dependent on alcohol than those who did not. The study also indicated that people who suffer from alcohol dependency have probably been exposed to a traumatic event in their lives (Fetzner, McMillan, Sareen, & Asmundson, 2011). This substance abuse dependency can cause physical harm, emotional harm, and over time destroy one’s life.

A study was conducted to see the relationship between physical aggression, non-physical aggression, and Iraq and Afghanistan war veterans. The study assessed questionnaires taken by 337 veterans and found that for non-physical aggression, rates were much high in veterans with symptoms of PTSD and when combined with alcohol abuse. This abuse in alcohol combined with PTSD symptoms also increased the rate of physical aggression (Stappenbeck, Hellmuth, Simpson, & Jakupcak, 2013). It is not surprising that PTSD raises the dependency of alcohol and increases overall aggression.

In a study conducted to show the relationship strain that veterans with PTSD have with their significant others, the more symptoms a service member reported of PTSD (especially numbing and withdrawal), the higher level of relationship stress the significant other reported. It was suggested that much of the stress is due to the perception that the significant other has about these numbing and withdrawing feelings. Many feel that they are directed towards them on a personal level where as the reality is that these feelings have nothing to do with the relationship, they are just symptoms of the PTSD. Simply put, “it’s not you, it’s me” (Renshaw & Campbell, 2011). The Department of Veterans Affairs reported that almost 40% of Vietnam veteran marriages failed within six months after returning from war (Department of Veterans Affairs, 2013). They also reported a study with 50 Vietnam veteran participants where 42% reported physical domestic abuse and 92% reported verbal abuse in the year after their return from war (Department of Veterans Affairs, 2013). These studies show that PTSD is not only an issue for the veteran who is suffering, but also for their families.

In a study that showed a relationship between PTSD and suicide it was reported that people with PTSD are twice as likely than those without PTSD to attempt suicide (Sher, 2009). In a report from the Department of Veterans Affairs, the number of veterans who participated in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn and now suffer from PTSD were totaled to 286,134 veterans from October 2001 until September 2012 (Department of Veterans Affairs, 2012). According to the Department of Veteran’s Affairs, a total of 27,062 veterans committed suicide between the years of 2009 through 2012. This is an average of 22 veterans per day committing suicide (Department of Veterans Affairs, 2012). In a report on Operation Iraqi Freedom veterans and Operation Enduring Freedom veterans there was a reported 490,346 suicides (Lee, 2012). This is a horrendous amount of suicides.

It is evident that there is a significant amount of posttraumatic stress in veterans and active duty service members. Many of these veterans suffer from alcohol and drug dependencies, family issues with spouses and children, many homeless veterans suffer from PTSD, and many veterans are aggressive and prone to domestic violence and suicide.

Chapter 3: The Afflicted

Risk Factors


Risk factors are any sort of attribute that can increase the likelihood of a disease or disorder.

According to the National Institute for Mental Health, some common risk factors for PTSD are “living through dangerous events and traumas, having a history of mental illness, getting hurt, seeing people hurt or killed, feeling horror, helplessness, or extreme fear, having little or no social support after the event, and dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home” (National Institute for Mental Health, 2012). These

risk factors can increase an individual’s chance of suffering from PTSD. Many of these risk factors are experienced daily by service members and sadly some of these risk factors are what military members sign up to experience. Many members look for the adventure and excitement of the soldier life but may not realize what they are actually committing to.

The first risk factor listed, living through dangerous events and trauma, is a daily occurrence on a deployment, and many service members have been on more than one deployment. According to study conducted in 2005, the average service member will deploy 14 times in a 20-year career (Adler & Huffman, 2005). This means that a service member could possibly be exposed to traumatic events for 14 years.

The second and third risk factors are getting hurt or seeing someone get hurt. As of February 5, 2013, there have been a total of 4,409 deaths and 31,925 wounded in Operation Iraqi Freedom, 2,165 deaths and 18,230 wounded in Operation Enduring Freedom, and 66 deaths and 295 wounded in Operation New Dawn (Fischer, 2013). This is an enormous risk factor for PTSD in veterans. This data also shows that as of December 2012, there are a total of 103,792 veterans who suffer from PTSD that have deployed and 27,549 veterans that suffer from PTSD and did not deploy, meaning a service member does not have to be on a deployment to experience trauma and experience PTSD (Fischer, 2013).

A study conducted to see the relationship between prior brain trauma, PTSD, and suicide showed that veterans who suffer from PTSD will be more likely to commit suicide as well as those who have had prior brain trauma. The combination together (brain trauma and PTSD) show that there is an increased risk factor in suicide when both PTSD and brain trauma are present (Barnes, Walter, & Chard, 2012). In Fischer’s 2013 report on U.S. Military Casualty Statistics in Operation

New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom, there was a total of 253,330 reported traumatic brain injuries.

Feeling horror, helplessness, or extreme fear is again very common on any deployment. When a person is literally fighting for his or her life, there will be extreme fear and horror. When a person witnesses’ death of a comrade or a friend, there is an immense feeling of helplessness and even survivor’s guilt. The risk factors listed only require one to enhance the appearance of PTSD, most veterans experience five or six of these in a given setting, not to mention they experience them multiple times. It is obvious why the numbers of PTSD in veterans and service members are so high but what can we do to help? How can we lower the suicide rates and increase the number of veterans who seek help?

Chapter 4: Finding a way

Treatment


Currently the suggested treatment for PTSD is psychotherapy and medications, or a combination of both

(National Institute of Mental Health, 2013). It has been encouraged that the sooner a person addresses their PTSD and seeks help, the more likely they are to overcome it.


Psychotherapy:

Much of the psychotherapy used will encourage the individual to confront the traumatic event or events and address the feelings he or she might have associated with the trauma. This technique allows the individual to work through these feelings and work on healing. Other types of talk therapy could include cognitive behavioral therapy. This is where the individual will again confront his or her feelings about the trauma and try to identify the cause of their current feelings. Once these negative feelings have been identified, the individual can move forward and try to control them by rationalizing. Family therapy is also encouraged for people with PTSD. As mentioned before, PTSD can not only affect the one suffering but also that person’s family and friends. It is important to have family involved in this healing process so that they can address issues that may be causing stress on the family and work through them together. This will also help with the sense of disconnection and encourage feelings of partnership and embracement (Helpguide.org, 2013).

When it comes to veterans and service members, talk therapy is also detrimental for overall progress. For service members it can be difficult to move forward from a past event when they might be en route to experience another. Multiple deployments can have a significant effect on service members’ mental state, especially on those who are already suffering from PTSD. So how are they supposed to get over one event when the possibility of another is in their near future? Lee

(2012) suggests that it is an important step to be self-aware and for the service member to be open to finding help. Several branches of the military have started campaigns for suicide prevention where service members are encouraged to seek help if they are having symptoms of suicide or depression. The campaigns not only encourage members to come forward but there is also training for members to be supportive of those who need help on many levels. The Department of Veteran’s Affairs also offers many programs and support channels for veterans and family members with PTSD. According to a study about the Department of Veterans Affairs’ “REACH” program (Reaching out to Educate and Assist Caring, Healthy Families), veterans showed significant improvement in their overall lives and family lives (Fischer, Sherman, Han & Bowen, 2013).


Grouped Delivered Cognitive Behavioral Therapy:


Pharmacologic Treatments:

Types of medications that are sometimes used to treat PTSD are forms of antidepressants like Prozac or Zoloft. It has been recommended by many sources that talk therapy be the first type of treatment for PTSD and then if needed, a medication can be prescribed with it. Some medications are recommended to address any biological issues that might be present in PTSD.

A study conducted a test to see how soldiers that were deployed to Iraq reacted to different kinds of treatment for PTSD. The results showed that the soldiers reacted significantly higher to exposure therapy than they did to medications. As suggested in previously stated studies, medication is really the last step for PTSD treatment (Reger, Durham, Tarantino, Luxton, Holloway, & Lee, 2012).



Animal-Assisted Therapy:

Conclusion

There is a significant number of veterans and active duty service members who suffer from PTSD. This disorder not only affects them on a psychological level but also on a physical, emotional, and relational level. The symptoms not only harm the veteran, but it can also take a tremendous toll on the family and friends. Whether it is alcohol or substance abuse, heighten levels of aggression, failing marriages, or suicide, these veterans are suffering in many ways. These symptoms are brought on by such risk factors as experiencing dangerous events, getting hurt, seeing people killed, and feeling extreme fear which can be somewhat near impossible to avoid as a deployed soldier, but what is most important is that these people seek assistance and support after going through the trauma. There have been incredible advances in the past 10 years for support and treatments for PTSD in service members and veterans that are encouraging more and more to come forward, address their issues, and start the healing processes. These people sacrifice their lives, their family, their time, their everything so that this country can sleep peacefully at night, the least we could do is ensure they share that same luxury. If you are a veteran struggling with PTSD, the greatest display of strength you can show is to

reach out for help

.

References


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Creative ways to facilitate client care between many different types of agencies.

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Creative ways to facilitate client care between many different types of agencies.

For this Assignment, imagine you are an administrator (choose your path assignment) who faces funding problems because your major funder has determined that your clients do not have proper access to services. Many of the access to service issues are community based, so you contact your peers in the town to design a plan that allows clients to access needed services quicker. Continue on the same path as you initially selected—you are one step closer to graduation now!

In a 4-5 page paper, design a plan for service delivery between multiple agencies that reduces paperwork and intake time. Be sure to include the following in your design:

1.List some typical obstacles that interfere with the clients’ ability to access services across agencies.

2.What are some creative ways to facilitate client care between many different types of agencies (e.g., food bank, mental health agency, welfare to work)?

3.Often agencies have service-specific rules and laws that they must follow. Remember that most agencies must now follow HIPAA regulations; think about how you can use this knowledge to your advantage. What suggestions do you have for helping agencies in your town to streamline the intake process? Are there ways to facilitate access to services by eliminating some of the intake procedures? Why or why not?

4.How does this plan eliminate the identified obstacles that interfere with the clients’ ability to access services at different agencies?

Suggested Format:

•Title page (Coffeetown Problem)

•Introduction (question one information-at least a half page)

•Use theories and problem-solving from your studies (questions 2 and 3-at least two and a half pages)

•Evaluation of the plan’s effectiveness (question 4-at least a half page)

Use your notes from past classes listed in the Reading and conduct research as needed (by calling people who work in human services in your area). This Assignment should be written using the guidelines of Standard American English and should be between 800 and 1000 words, not including the title page and the reference page. You are required to give credit to the sources you use and use proper APA formatting. Refer to the APA Quick Reference Guide, the Kaplan Writing Center, or your instructor for help with APA. Remember that all work must be your own, and plagiarism is not tolerated. Be sure to review the plagiarism policy in your Syllabus.

Select one article from a nursing journal focused on a cultural group.

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Select one article from a nursing journal focused on a cultural group.

 

Write a paper of 1,000-1,250 words on a specific cultural group. Use the following guidelines:

1. Select one article from a nursing journal focused on a cultural group.

2. In the introduction, state your reason for selecting the cultural group.

3. Summarize the key points of the article.

4. Apply the new information to a practice situation that demonstrates cultural sensitivity in communication, reflecting the reading in chapter 25.

5. Write a conclusion.

Prepare this assignment according to the APA guidelines found in the APA Style Guide

Advocate for policies that improve the health of the public and the profession of nursing Readings: See Module 4 to select a contemporary issue for your editorial piece. Module 4 Readings:

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Advocate for policies that improve the health of the public and the profession of nursing
Readings: See Module 4 to select a contemporary issue for your editorial piece.
Module 4 Readings:

1. Advocate for nursing values and to shape the healthcare delivery system
2. Understand the legal and political determinants of the healthcare
3. Examine the effect of contemporary regulatory obstacles to advancing nursing practice healthcare delivery and outcomes.
4. Advocate for policies that improve the health of the public and the profession of nursing
Readings: See Module 4 to select a contemporary issue for your editorial piece.
Module 4 Readings:
1. Patel K.m Masi. D. (2015). Five ways Obamacare has improved your healthcare. Brookings Institute. Access https://www.newsweek.com/five-ways-obamacare-has-improved-your-health-care-315909
2. Nix K. (2016). Obamacare Undermines Physicians Quality of Care. Heritage Foundations Center for Health Policy Studies. Access https://www.heritage.org/research/commentary/2012/08/obamacare-undermines-physicians-quality-of-care
3. Pipes S. 2008. Myth Six: Universial coverage can be achieved by forcing everyone to buy health insurance. In Top Ten Myths of American Health Care. San Francisco: Pacific Research Institute. Pp 65-80
4. Pipes S. 2008. Myth Three: Forty-six million Americans cant get health care. In Top Ten Myths of American Health Care. San Francisco: Pacific Research Institute. Pp 31-40
5. No author. (2014). Study: Pre-Obamacare Health Insurance was better quality than exchange plans. Phylly.com posted 9-18-14. Access https://www.philly.com/health/healthcare-exchange/275507221.html#mEsBWKyudpW9Fddl.99
6. Mckinney M. (2011). About that Quality Chasm. Modern Healthcare Access http:www.modernhealthcare.com/article/20110221/magazine/110219950
ASIIGNMENT:
1. Select a contemporary regulatory obstacle to full authority advanced practice nursing
2. Identify a publication source and its criteria for authors (separate page)
3. Write a 500-word persuasive editorial(submissionis optional)
4. Use the Rubric for writing a persuasive editorial for guidance

Discuss the five (5) levels of Maslow’s hierarchy of needs, and give an example of each level.

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Discuss the five (5) levels of Maslow’s hierarchy of needs, and give an example of each level.

 

Psychology of Personality

Answer the following questions. Your answer to each question should be in the range of 500-700 words

1. Discuss the third force in psychology and how it differs from the first and second forces. (Chapter 10)

2. Discuss the five (5) levels of Maslow’s hierarchy of needs, and give an example of each level.

.Describe why you wish to be a Cook Children’s nurse resident. 2.Describe your goals and expectations at the completion of the nurse residency. 3.Explain how you demonstrate two of the Cook Children’s values, which include caring, safety, integrity, coll.

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.Describe why you wish to be a Cook Children’s nurse resident. 2.Describe your goals and expectations at the completion of the nurse residency. 3.Explain how you demonstrate two of the Cook Children’s values, which include caring, safety, integrity, coll.

.Describe why you wish to be a Cook Children’s nurse resident. 2.Describe your goals and expectations at the completion of the nurse residency. 3.Explain how you demonstrate two of the Cook Children’s values, which include caring, safety, integrity, coll

Paper details:

submit an essay covering ALL 4 topics mentioned above. I will go into more detail below about each topic. Here is a link to the application requirements if you would like to get a better idea of the hospital and so forth. http://www.cookchildrens.org/SpecialtyServices/Nursing/nurseresidency/critical-care/Pages/default.aspx Here are some ideas related to each topic that I ask you include (in a more formal manner of course though, please). 1. I am very interested in the pediatric field of nursing and love the idea of getting to rotate through different areas throughout the residency. Cooks Children’s is a prestigious hospital with lots of acknowledgement and recognition. 2. My goals and expectations are to be confident and comfortable in my nursing skills with the pediatric population. I expect to learn a tremendous amount of information and skills throughout the residency and hope to continue my passion working with children after completion. 3. The two values I ask you to focus on are caring and integrity. Nursing is so much more than getting by doing the bare minimum. I want to focus on going above and beyond for my patients and being an extreme patient advocate. Sometimes, it’s the simplest things that have the greatest impact on a patient. For example, just taking the time to sit and talk to a patient that may be lonely or just needs someone to talk to. Nursing is so much more than passing meds, and doing a quick assessment… it involves emotional, psychiatric, and physical implications that are specific to each and every individual patient. 4. I have always had a passion for children and would be so blessed and excited to be able to experience such a wonderful program. (something along those lines for this topic please) You can google Cook Children’s Ft. Worth, Texas to get a better idea of the hospital and its values and all that! If you have any questions at all, please contact me. Please include these details in a more formal manner.

Principals of macroeconomics | Economics homework help

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